China's Medical Insurance Fund Exceeds 3 Trillion Yuan as Costs Rise

China’s basic medical insurance fund recorded a total expenditure of 3.0055 trillion yuan in 2025, surpassing the 3‑trillion‑yuan threshold for the first time. The 2025 statistical report shows total income of 3.5921 trillion yuan and a surplus of 525.77 billion yuan, with an average daily outflow of more than 80 billion yuan to hospitals, pharmacies and insured persons. The employee‑to‑retiree contribution ratio fell to 2.6, meaning each 2.6 active contributors support one retiree, continuing a downward trend that pressures the working‑age population.

At the same time, Hong Kong’s voluntary health insurance scheme (VHIS) shows premiums rising sharply with age. Official data from the Health Bureau list standard‑plan annual premiums for non‑smokers: at age 40, premiums range from HK$2,304 (Bowtie) to HK$4,796 (HSBC); at age 50, from HK$3,612 (Bowtie) to HK$7,522 (Bupa); and at age 60, from HK$5,568 (Bowtie) to HK$17,973 (Bupa). Premiums generally increase 1.5–3 times between ages 40 and 60, prompting experts to recommend early enrollment to reduce lifetime costs.

Both reports highlight growing financial strain on China’s health‑care financing system, with rising payouts and an aging population increasing the burden on younger workers and insurance purchasers.